Child abuse
[4] In an 1860 paper, French forensic medical expert Auguste Ambroise Tardieu gathered together a series of 32 such cases, of which 18 were fatal, the children dying from starvation and/or recurrent physical abuse; it included the case of Adeline Defert, who was returned by her grandparents at the age of 8, and for 9 years tortured by her parents – whipped every day, hung up by her thumbs and beaten with a nailed plank, burnt with hot coals and her wounds bathed in nitric acid, and deflorated with a baton.
He commented, "When we consider the tender age of these poor defenceless beings, subjected daily and almost hourly to savage atrocities, unimaginable tortures and harsh privation, their lives one long martyrdom – and when we face the fact that their tormentors are the very mothers who gave them life, we are confronted with one of the most appalling problems that can disturb the soul of a moralist, or the conscience of justice".
[9][10][11] These early French observations failed to cross the language barrier, and other nations remained ignorant of the cause of many traumatic lesions in infants and toddlers; almost one hundred years would pass before humankind began to systematically confront Tardieu's "appalling problem".
[13] In 1946, John Caffey, the American founder of paediatric radiology, drew attention to the association of long bone fractures and chronic subdural haematoma,[14] and, in 1955, it was noticed that infants removed from the care of aggressive, immature and emotionally ill parents developed no new lesions.
[16] The July 1962 publication of the paper "The Battered Child-Syndrome" authored principally by pediatrician C. Henry Kempe and published in The Journal of the American Medical Association represents the moment that child maltreatment entered mainstream awareness.
Another effect of the way child abuse and neglect have been studied, according to Young-Bruehl, was to close off consideration of how children themselves perceive maltreatment and the importance they place on adults' attitudes toward them.
Since members of these various fields tend to use their own definitions, communication across disciplines can be limited, hampering efforts to identify, assess, track, treat, and prevent child maltreatment.
[16] Some health professionals and authors consider neglect as part of the definition of abuse, while others do not; this is because the harm may have been unintentional, or because the caregivers did not understand the severity of the problem, which may have been the result of cultural beliefs about how to raise a child.
[41][42] These symptoms may include: fractures of bones, multiple soft tissue injuries, subdural hematoma (bleeding in the brain), malnutrition, and poor skin hygiene.
), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression,[50] PTSD,[51] anxiety,[52] other mental illnesses including borderline personality disorder,[53] propensity to re-victimization in adulthood,[54] bulimia nervosa,[55] and physical injury to the child, among other problems.
Such children are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents.
These children seem to have learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through childhood.
Data from the Centers for Disease Control and Prevention (CDC) and Behavioral Risk Factor Surveillance System corroborate these high rates.
[110] There is a high correlation between the number of different adverse childhood experiences (A.C.E.s) and risk for poor health outcomes in adults including cancer, heart attack, mental illness, reduced longevity, and drug and alcohol abuse.
[130] At the level of society, factors contributing to child maltreatment include cultural norms that encourage harsh physical punishment of children, economic inequality, and the lack of social safety nets.
Studies indicate that such abusive treatment often involves parents attributing conflict to their child's willfulness or rejection, as well as "coercive family dynamics and conditioned emotional responses".
One U.S. study found that parents with documented substance use, most commonly alcohol, cocaine, and heroin, were much more likely to mistreat their children, and were also much more likely to reject court-ordered services and treatments.
She contends that such prejudice, while not the immediate cause of child maltreatment, must be investigated in order to understand the motivations behind a given act of abuse, as well as to shed light on societal failures to support children's needs and development in general.
He writes, "the roots of child abuse lie not in parental psycho-pathology or in socio-environmental stress (though their influences cannot be discounted) but in a sick culture which denigrates and depersonalizes, which reduces children to property, to sexual objects so that they become the legitimate victims of both adult violence and lust".
Poverty and substance use disorders are common social problems worldwide, and no matter the location, show a similar trend in the correlation to child abuse.
While controlling parenting may be less of a concern, financial difficulty, unemployment, and substance use remain dominating factors in child abuse throughout Eastern Europe.
[157][158][159] In April 2015, public broadcasting reported that the rate of child abuse in South Korea had increased to 13% compared with the previous year, and 75% of attackers were the children's own parents.
Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child's immediate need for safety.
Also, girls are particularly vulnerable to sexual violence, exploitation and abuse in situations of armed conflict and refugee settings, whether by combatants, security forces, community members, aid workers, or others.
[227][228] In Canada, the Canadian Indian residential school system involved First Nations, Métis and Inuit children, who often suffered severe abuse.
[229][230][231][232][233] As part of the persecution of Uyghurs in China, in 2017 alone at least half a million children were also forcefully separated from their families, and placed in pre-school camps with prison-style surveillance systems and 10,000 volt electric fences.
[254] A tradition often performed in some regions in Africa involves a man initiating a girl into womanhood by having sex with her, usually after her first period, in a practice known as "sexual cleansing".
[273] For example, in southern Ethiopia, children with physical abnormalities are considered to be ritually impure or mingi, the latter are believed to exert an evil influence upon others, so disabled infants have traditionally been disposed of without a proper burial.
[287][288][289] Bioethicists Jacob M. Appel and Thaddeus Mason Pope recently argued, in separate articles, that such cases justify the replacement of the accused parent with an alternative decision-maker.
Investigations into child abuse are handled by Provincial and Territorial Authorities through government social service departments and enforcement is through local police and courts.
